Managed Care Specialist (RN or LPN)
Company: Brickyard Healthcare
Location: Indianapolis
Posted on: May 3, 2025
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Job Description:
We rely on and trust our Managed Care Specialist (RN or LPN) to
provide centralized or field based case management for managed care
and commercial insurance payers and residents. The right candidate
for this role is a dedicated and compassionate team-player.Why Work
For Us?Competitive PayExcellent health benefits packagesCareer
advancement opportunitiesEducation reimbursement program of up to
$7,500 per yearFlexible scheduling availableBenefits &
Conditions:No waiting period for enrollmentThree health plan
optionsDelta DentalVSP VisionFree Basic Life InsuranceDisability,
Critical Illness, Accident & Legal Coverage401(k) Retirement
PlanEmployee Assistance ProgramResponsibilities:Communicates care
plan to insurance case managers with emphasis on strong discharge
planningCommunicates, negotiates, and acts as liaison between
Living Center/ Agency and the insurance plan to ensure proper level
of payment is assigned for services providedCommunicates insurance
benefits to all levels of associatesUnderstands provisions of
contracts and associated exclusionsWork closely with facility and
external support staff for negotiation of services and
ratesConsults on appeals, retro authorizations and collections
issuesManage and maintain a live Spreadsheet to reflect changes in
authorizations and continued stay reviews as they occurInitiate,
confirm and update facility and external staff on status of
AuthorizationsWork with insurance companies to ensure discharge
disposition and documents are shared timelyPrep and submit
insurance continued stay requests dailyNavigate the insurance,
signing and return of NOMNC between insurance and facility
staffObtain and Maintain copies of authorizations in member folders
as well as in PCC documentsSubmit requests for cost out of
high-cost drugs with Prior authorizations as well as concurrent
reviewsQualifications:Licensed as a Registered Nurse (RN) or
Licensed Practical Nurse (LPN)Minimum 2 years experience with
insurance providers preferredMinimum 2 years' experience in a
long-term care setting preferredMust be capable of maintaining
regular attendance#BYHCINDby Jobble
Keywords: Brickyard Healthcare, Bloomington , Managed Care Specialist (RN or LPN), Healthcare , Indianapolis, Indiana
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